This study aims to compare the efficiency of APACHE IV with that of MELD scoring system for prediction of the risk of mortality risk after orthotopic liver transplantation (OLT). A retrospective cohort study was performed based on a total of 195 patients admitted to the ICU after orthotopic liver transplantation (OLT) between February 2006 and July 2009 in Guangzhou, China. APACHE IV and MELD scoring systems were used to predict the postoperative mortality after OLT. The area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow C statistic were used to assess the discrimination and calibration of APACHE IV and MELD, respectively. Twenty-seven patients died during hospitalization with a mortality rate of 13.8%. The mean scores of APACHE IV and MELD were 42.32 ± 21.95 and 18.09 ± 10.55, respectively, and APACHE IV showed better discrimination than MELD; the areas under the receiver operating characteristic curve for APACHE IV and MELD were 0.937 and 0.694 (P < 0.05 for both models), which indicated that the prognostic value of APACHE IV was relatively high. Both models were well-calibrated (The Hosmer-Lemeshow C statistics were 1.568 and 6.818 for APACHE IV and MELD, resp.; P > 0.05 for both). The respective Youden indexes of APACHE IV, MELD, and combination of APACHE IV with MELD were 0.763, 0.430, and 0.545. The prognostic value of APACHE IV is high but still underestimates the overall hospital mortality, while the prognostic value of MELD is poor. The function of the APACHE IV is, thus, better than that of the MELD.

Burn injuries are a significant global public health concern. The psychological problems deserve more attention. Research has shown that reducing the stigma and improving the burn patient’s self-esteem are effective means to promote social reintegration. The aim of this study is to explore the relationship between stigma and self-esteem and to examine the independent factors that contribute to with the stigma of burns. The convenience sampling method was used in Guangzhou, China. A cross-sectional study was conducted using the Social Impact Scale, Rosenberg Self-Esteem Scale, and a sociodemographic questionnaire. Descriptive statistics, statistical inference, correlation testing, and regression analysis were used to analyze the data among 146 burn survivors. The P-value was set as .05. The mean score of SIS was 57.03 ± 6.762. Of the four components of the Social Impact Scale, social rejection had the highest mean score (21.72 ± 3.00). The mean Self-Esteem Scale score was 21.05 ± 2.492, markedly different from the general population. A moderate positive correlation (r = .546, P &lt; .001) was found between stigma and low self-esteem among burn victims. Multiple linear regression analysis identified residence, itching, and Self-Esteem Scale score as significant influencing factors, accounting for 38.5% of the total variance in stigma. Burn survivors reported moderate levels of stigma and low levels of self-esteem. Residence, itching, and Self-Esteem Scale score were significant influencing factors for stigma. To promote recovery of patients with burn injury, it is necessary to eliminate the stigma and improve their self-esteem.

No abstract